Microsurgery Tutorials. Lesson 7: End-to-end Anastomosis, Rat Aorta скачать в хорошем качестве

Microsurgery Tutorials. Lesson 7: End-to-end Anastomosis, Rat Aorta

A series of tutorials on microsurgery, starting from the basics working up to more advanced techniques, uploaded in random order. All videos:    / drwmicrosurgery   Copyright 2012 Victor Volovici (DrW). Carl Zeiss Opmi Pico Microscope, blue filter applied, magnification 20x. The abdominal aorta is carefully dissected from the surrounding tissues, with extra care given to mobilize the Inferior Vena Cava as little as possible. The collaterals need to be ligated. The site for anastomosis must be carefully selected so as not to create functional impairment after surgery is complete. This is the subject of lesson 6. A background is placed (making sure not to touch the IVC), after which the vascular approximator (clip) is applied. This can be done either by hand or by using an applier. After the vessel is carefully positioned with care given so that it is not rotated, it is cut with a single move in order to achieve a single precise cut. The ends are then treated with heparinized saline and lidocaine to avoid vasospasm. The cardinal sutures are then placed, one at the distal end of the vessel and one at the proximal end. One must not rush when inserting the needle, careful calculation and planning and meticulous technique are paramount at this point and at every suture that follows! We do not show the second cardinal suture and jump directly to the posterior wall. Here, the first suture is placed exactly in the middle, as per the triangulation method followed by 2 more sutures placed on its either side, halfway between it and the cardinal sutures. Finally, the anterior wall is completed with one middle suture. Other sutures may be necessary, depending on the size of the thread being used. Due to shortage of funds, we were forced to use 8/0 USP prolene for this video, which explains the minimal bleeding seen when opening the distal end of the approximator. However, when proper technique is used, opening the proximal end yields no bleeding and the aorta is seen pulsating and filled with blood. The rat is then closed with 7/0 absorbable sutures, first the peritoneum, then the muscular layer and finally the skin, approximately 25-30 sutures each. She had an excellent recovery with paracetamol used for postop analgesia and is now able to be socially reintegrated. More videos to come! Song: Tchaikovsky Concerto for violin and orchestra in D major. I do not own or claim authorship for the song.